Saskatchewan Workers' Compensation Board   In serving injured workers and employers, our vision 
is to excel in the development and delivery of workers' compensation and injury prevention programs and services.
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Appeals
The number of incoming appeals was up marginally to a total of 1064 in 2008. There was also an increase in the number of appeal decisions, reducing the backlog slightly from 2007.

Ease of access is a critically important aspect of the Workers' Compensation appeal process. At the Appeals Department level, almost 70% of appellants are self-represented workers. All that is required is a written request for reconsideration and the Appeals Department will ensure an independent and thorough review. The appellant may ask for an appeal hearing and is encouraged to submit additional information and evidence for consideration.

The Appeals Department has a strong focus on accountability and evidence based decision making. Appeals Officers have a broad range of experience in WCB claims adjudication and management. To help ensure continued accuracy and consistency in decision making, all Appeals Officers received professional Administrative Justice training in 2006 through 2008, with plans to continue professional development activities in 2009.

While the accuracy of an appeal decision is critical, the Appeals Department has established goals to deliver decisions in a timely manner. When an appeal is registered, clients are advised of the approximate time frame for their appeal to be considered. Appellants with electronic access to their claim file may track the status of their appeal online.

The backlog and cycle times improved again in 2008. The backlog at the end of 2008 was at 115 appeals compared to 142 at the end of 2007. The average cycle time was also lower, fluctuating between 45 and 50 days in 2008, compared to 65 days at the end of 2007. While not quite meeting internal target levels, this cycle time is among the best of Canadian Workers' Compensation Board internal appeal departments.

Statistics

Appeals Activity
 2008 2007 2006 2005 2004
Appeals Received 1064 1021 1008 1149 1077
Accepted 202 217 209 254266
Denied 603546 534 801639
Returned for Development 264246 190259 231
Total 1069 1009933 1314 1136
Withdrawn 22 23 42 22 42
Appeals Pending 115 142153 120 307
      
Average days to decision 48 65 51 77 157
Appeals decided within 30 days 22.4% 21.0% 24.3% 26.3% 21.9%
Appeal Meetings 44 53 44 75 98


Source of Appeals
 2008 2007 2006 2005 2004
Source      
Worker 718 722 671 820 717
Worker's Advocate141 118 109 95 114
Employer 7870 73 65 75
Union Official 37 36 31 24 49
Lawyer 17 17 28 35 32
Family 7 6 310 5
Other Representatives 66 5293 10085
Total 1064 1021 1008 1149 1077


Nature of Appeals
 2008 2007 2006 2005 2004
Issue     
Initial Acceptance 354 333 317 359 290
Relationship (of condition to injury) 151 164 176 216 177
Recovery / Fitness68 8398 140 189
Expenses 8169 47 7729
Recovery / Pre-existing condition 51 5957 27 67
Wage Loss Benefits 70 57 13 ** **
Estimated Earning Capacity 58 51 49 55 74
Cost Relief for Employer 46 3970 59 67
Permanent Functional Impairment 26 3429 4442
Suspension 4832 31 4643
Wage Base 34 29 34 32 24
Retraining 15 2018 23 23
Independence Allowance 4 18 1322 8
Overpayment Recovery26 17 15 42
Dependants4 3 1 6 0
Other 28 13 40 39 42
Total 1064 1021 1008 1149 1077
** New Category of appeals in 2006

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Employer Appeals
The WCB's Revenue and Employer Accounts (REA) Department is responsible for employer registration, industry classification, experience rating and other issues that affect an employer's WCB account. The process for all REA appeals (except for experience rating) is a two-step process.

The Employer Services Representative (ESR) or Quantitative Research Analyst (QRA) who made the decision is asked to review it. Many issues can be resolved at this stage.

If the matter is not resolved, the employer can appeal to REA's Assessment Committee. The Committee will review the file and advise the employer of their decision.

Appeals Activity
  2008 2007 2006*
Appeals Received 14 27 28
Accepted 5 8 9
Denied 7 19 18
Outstanding 2 0 1
Total 14 27 28
       
Experience Rating Accepted 0 3 5
Experience Rating Denied 4 12 9
Classification Accepted 4 3 4
Classification Denied 0 4 6
Coverage Accepted 1 1 0
Coverage Denied 1 1 1
Other Accepted 0 1 0
Other Denied 2 2 2
Total 12 27 27
* Comparative data is not available prior to 2006

Final Level Appeals
Clients not satisfied with the outcome of the first level appeal by the Appeals Department or the Assessment Committee can request to have the issue reviewed by the WCB Board Members. The Board Members act as the final level of appeal for all matters unless there is a bona-fide medical question to be decided. A bona-fide medical question may be referred to a medical review panel of physicians.

Appeals Activity
  2008 2007 2006 2005 2004
Appeals Received 219 208 233 308 284
Decisions Made          
Accepted 102 124 110 108 115
Denied 93 97 113 139 152
Total 195 221 233 247 267
Appeals Withdrawn 16 10 15 14 19
Appeals Pending 105 100 119 122 74
Average number days for decision 161 181 161 116 94
Oral Hearings 106 116 81 155 118

Source of Appeals
 2008 2007 2006 2005 2004
Worker's Advocate 103 86 108 120 102
Worker68 66 76 89 99
Employer 222827 26 33
Lawyer 10 8 4 13 11
Other Representatives 7 13 13 47 32
Union Official 7 5 39 5
Family 2 22 42
Total 219 208 233 308 284

Nature of Appeals
  2008 2007 2006 2005 2004
Initial Acceptance 82 54 65 69 61
Relationship 50 53 58 82 83
Recovery / Fitness 37 43 45 60 60
Cost Relief 11 17 6 26 21
Estimated Earning Capacity 9 9 10 14 14
Other 9 7 20 16 10
Transportation Expense 6 3 4 15 7
Wage Base 4 5 8 8 8
Suspension 4 5 3 2 3
Permanent Functional Impairment (PFI) 4 4 6 6 6
Retraining 3 34 2 4
Dependants0 0 0 1 1
Assessment Rates and Surcharge 0 5 4 7 6
Total 219 208 233 308 284


Medical Review Panels

Appeals Activity
  2008 2007 2006 2005 2004
Panels Held 12 17 15 11 7
Decisions Made          
Accepted 6 7 7 3 4
Denied 6 10 8 6 3
Total 12 17 15 9 7
Pending 0 0 0 2 0

Nature of Appeals
 2008 2007 2006 2005 2004
Relationship 7 14 12 9 6
Recovery/Fitness 5 2 2 2 0
PFI0 10 0 1
Other 0 0 1 0 0
Total 12 17 15 11 7

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